HomeMy WebLinkAboutBLD0423 Addition - BLD Permit / Conditions - 7/15/1986 TYPE ADDITION
Permit No. 0423 No. Floors Sq Ftg 768
Owner PATRICK, Guy Tel 275-4179 Date 7-15-86
Address NE 121 Rainbow Lane Belfair Zip
Contractor Self
Address Zip
Legal Description Mission Creek Tracts B1. 3, Lot 7
Direction to project site Down Northshore Rd. 4 mi.Right
on Mission Cr.Rd. 5th house on left
Plumbing x Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
Add bdrm. , bath, laundry room, rec room & storage
I
Shorelines: /y; �b
plMi, ;
.
Setback: Mechan
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detect
Remarks:
/�---
Setback:
Fbundation
Walls:
Framing:cr',C�/!� /G
Fireplace:
Wood Stove: EXPtRhT ' �
ANTE = - BY _
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 /5
DATE ISSUED_ Y
PERMITNO.
OWNER NAME MAIL ADDRESS CITY 3 STATE _ ZIP PHONE
lT i.t W'
DIRECTIONS Do w,1 4AaFk S Iojp r-c t-A 4 Vn k r,g�X7 O ,^ n'1 t ss,o b"k cr. v-1 sTi-ck%V hT o
TO JOB SITE La. U
LEGAL - /_ / , (❑ SEE ATTACHED SHEET)
DESCR. IS.S/ O /� ����/G �/��Z�T`� �� 3 Z<27 /
CONTRACTOR NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
USE OF
BUILDING - 7-1 0
Class of work: ❑ NEW ;9 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
1�
Valuation of work: $ PLAN CHECK FEE PERMIT FEE S d
3 00 .r -' 0 / y
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPOR ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE
9 ATTACHED LSERARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMEN AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTR TOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
76 C7 4 SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FO F F 1 C E USE ONLY
ordinance requirements regulating the work for which
the p mit is issued and all work done will be in
conf mance therewith. PERMANENT SHORELINES
SEASONAL ❑ FLOODPLAIN Li
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. N Date ZONING
PLANNING DEPT. �Z —
OWNERS AFFIDAVIT
HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT. �>
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
_ APPLICATION ACCEPTED BY LA��EC� APPROVE ISSUANCE
Owner Date . � fly/J BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
MASON COUNTY
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT— Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
1.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
/ WATER CLOSETS
i
I BASINSr i1
BATH TUBS
SHOWERS
WATER HEATERS
/ AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT '/ �. SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit tee Date pemit issued Permit number Receipt No.
$ � JD
CHRISTMASTOWN PRINTING
PLOT PLAN
ADDRESS A V „� I �(� I h LOW La4e _13 C- (a I'(- PERMIT NO 0 o
_ v
A r D
7 O
LEGAL - p
DESCRIPTION LOT BLK ADDITION u
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF (—
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS, SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A-'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
0 �1
1
�3.
zlk
1 ^^ M
� n
h
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
1 k
N AME(SI01F OWNER(S) OF SITE & STRUCTURE(SI (PRINT) SIGNATURE,*TrWNER(31 OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING